老年男性血清脂肪因子Irisin、Asprosin水平与骨质疏松性髋部骨折的相关性

Correlation between Serum Adipokine Irisin and Asprosin Levels and Osteoporotic Hip Fracture in Elderly Men

目的探讨血清脂肪因子鸢尾素(Irisin)、白脂素(Asprosin)水平与老年男性骨质疏松性髋部骨折的关系。方法选取2020年6月—2022年6月收治106例老年男性骨质疏松症作为病例组,另选取同期体检的80名老年男性健康人群作为对照组。根据纳入骨质疏松症患者是否发生髋部骨折再分为髋部骨折组(n=44)和无骨折组(n=62)。采用酶联免疫吸附试验检测所有受试者血清Irisin、Asprosin水平,骨密度仪测量骨质疏松症患者股骨大粗隆、健侧股骨颈、第1~4腰椎骨密度,采用受试者工作特征(ROC)曲线评估血清Irisin、Asprosin水平对老年男性骨质疏松性髋部骨折的预测价值,采用多因素Logistic回归分析探讨老年男性骨质疏松性髋部骨折的影响因素。结果病例组血清Irisin、Asprosin水平高于对照组(P<0.01)。髋部骨折组血清Irisin、Asprosin水平高于无骨折组(P<0.01)。血清Irisin、Asprosin联合预测老年男性骨质疏松症患者发生髋部骨折的曲线下面积为0.907(95%CI:0.862,0.952)。股骨颈骨密度≤0.77 g/cm^(2)、血清Irisin≥140.26 ng/mL、血清Asprosin≥2.75 ng/mL是老年男性骨质疏松症患者并发髋部骨折的独立危险因素(P<0.01)。结论血清Irisin、Asprosin水平升高是老年男性骨质疏松症患者髋部骨折发生的危险因素,二者联合预测老年男性骨质疏松性髋部骨折具有重要的临床价值。

Objective To investigate the relationship between serum levels of adipokine Irisin and Asprosin and osteoporotic hip fracture in elderly men.Methods In total,106 elderly male patients with osteoporosis treated from June 2020 to June 2022 were selected as the case group,and 80 healthy elderly males who underwent physical examination during the same period were selected as the control group.Patients with osteoporosis were divided into the hip fracture group(n=44)and the non-hip fracture group(n=62)according to whether they had a hip fracture.Serum Irisin and Asprosin levels of all subjects were detected by enzyme-linked immunosorbent assay(ELISA).Bone density of the femoral greater trochoid,healthy femoral neck and the 1st-4th lumbar vertebra in patients with osteoporosis was measured by bone densitometer.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum Irisin and Asprosin levels for osteoporotic hip fracture in elderly men.Multivariate Logistic regression analysis was used to explore the influencing factors of osteoporotic hip fracture in elderly men.Results The levels of serum Irisin and Asprosin in case group were higher than those in control group(P<0.01).The levels of serum Irisin and Asprosin in hip fracture group were higher than those in non-hip fracture group(P<0.01).The area under the ROC curve(AUC)of serum Irisin and Asprosin in combination in predicting hip fracture in elderly men with osteoporosis was 0.907(95%CI:0.862,0.952).Femoral neck bone mineral density≤0.77 g/cm^(2),serum Irisin≥140.26 ng/mL and serum Asprosin≥2.75 ng/mL were independent risk factors for hip fracture in elderly male patients with osteoporosis(P<0.01).Conclusion The increase of serum Irisin and Asprosin levels is a risk factor for hip fracture in elderly men with osteoporosis,and the combination of the two levels has important clinical value in predicting the incidence of osteoporotic hip fracture in elderly men.